Oxidant and Antioxidant Status in Patients with Rheumatoid Arthritis Treated by Methotrexate

Abstract

Abstract:Background: Rheumatoid arthritis (RA) is a debilitating, chronic multisystem disease with an unknown etiology. Recent findings indicated that increased oxidative stress and/or defective antioxidant status contribute to the etiology of RA. Cardiovascular mortality are increased in patients with rheumatoid arthritis and drugs used to treat RA may affect cardiovascular outcomes.Objectives: To find the effect of methotrexate on the oxidant /antioxidant status in female patients with RA in comparison with female patients with RA not treated by methotrexate and the healthy control in Mosul City / Iraq.Methods: Case control study.Study period: Period from April 2009 to April 2010.Subjects & Method: This study included 40 female patients, 20 of them were RA not treated by methotrexate and the other 20 patients were RA patients treated by methotrexate. Another 20 healthy women were drawn from the same population and matched for age, with the patients group and they were considered the control group.- Serum of venous blood from all patients kept frozen at – 20°C to be analyzed thereafter for the estimation of oxidant and antioxidant parameters.Results: A significant higher level of malondialdehyde (MDA) but non significant difference of PN2 level. Glutathione peroxidase (GSH-Px) was significantly lower but ceruloplasmin and superoxide dismutase (SOD) levels were significantly higher in RA patients without methotrexate therapy in comparison with healthy control. MDA level was significantly lower but PN2 level non significantly lower in RA patients on methotrexate therapy in comparison with RA patients without methotrexate therapy. Glutathione peroxidase (GSH-Px) is significantly higher but ceruloplasmin and SOD level is significantly lower in RA patients on methotrexate therapy in comparison with RA patients without methotrexate therapy. Conclusion: The finding of this study suggested that methotrexate treatment for RA patients causes a reduction in oxidative stress which is cardiovascular risk factors and increase some parameters of antioxidants (especially GSH-Px) of these patients.Key words: Rheumatoid arthritis, methotrexate, malondialdehyde, glutathione.